HEALTH ENCYCLOPEDIA

Ischemic Colitis

What is ischemic colitis?

Ischemic colitis (IC) is an inflammatory
condition of the large intestine, or colon. It develops when there isn’t enough
blood flow to the colon. IC can occur at any age, but it’s most common among
those over the age of 60.

A buildup of plaque inside the arteries (atherosclerosis)
can cause chronic, or long-term, IC. This condition may also go away with mild
treatment, such as a short-term liquid diet and antibiotics.

IC is also known as mesenteric artery
ischemia, mesenteric vascular disease, or colonic ischemia. A
blood clot usually causes acute (sudden and
short-term) IC. Acute IC is a medical emergency and requires treatment quickly.
The mortality rate is high if gangrene, or death of tissue, occurs in the colon.

What causes ischemic colitis?

IC occurs when there’s a lack of blood flow
to your colon. The hardening of one or more of the mesenteric arteries may
cause a sudden reduction in blood flow, which is also called an infarction.
These are the arteries that supply blood to your intestines. The arteries can
harden when there’s a buildup of fatty deposits called plaque inside your
artery walls. This condition is known as atherosclerosis. It’s a common cause
of IC among people who have a history of coronary artery disease or peripheral vascular disease.

A blood clot can also block the mesenteric
arteries and stop or reduce blood flow. Clots are more common in people with an
irregular heartbeat, or arrhythmia.

What are the risk factors for
ischemic colitis?

IC most often occurs in people who are over
60 years old. This may be because arteries tend to harden as you get older. As
you age, your heart and blood vessels need to work harder to pump and receive
blood. This causes your arteries to weaken, making them more prone to plaque
buildup.

What are the symptoms of ischemic
colitis?

Most people with IC feel mild to moderate abdominal
pain. This pain often occurs suddenly and feels
like a stomach cramp. Some blood may also be present in the stool, but the
bleeding shouldn’t be severe. Excessive
blood in the stool may be a sign of a different
problem, such as colon cancer, or an
inflammatory bowel disease like Crohn’s disease.

A mesenteric angiogram is an
imaging test that uses X-rays to see inside your arteries and
determine the location of the blockage.

A blood test can check for a white
blood cell count. If your white blood cell count
is high, it may indicate acute IC.

How is ischemic colitis treated?

Mild cases of IC are often treated with:

antibiotics (to prevent
infection)

a liquid diet

intravenous (IV) fluids (for
hydration)

pain medication

Acute IC is a medical emergency. It may
require:

thrombolytics, which are
medicines that dissolve blot clots

vasodilators, which are medicines
that can widen your mesenteric arteries

surgery to remove the blockage in
your arteries

People with chronic IC usually only need
surgery if other treatments fail.

What are the potential
complications of ischemic colitis?

The most dangerous complication of IC is
gangrene, or tissue death. When blood flow to your colon is limited, the tissue
can die. If this occurs, you may require surgery to remove the dead tissue.

Other complications associated with IC
include:

a perforation, or hole, in your
intestine

peritonitis, which is an inflammation of the tissue lining your abdomen

sepsis, which is a very serious and widespread bacterial infection

What is the outlook for people with IC?

Most people with chronic IC can be
successfully treated with medication and surgery. However, the problem may come
back if you don’t maintain a healthy lifestyle. Your arteries will continue to
harden if certain lifestyle changes aren’t made. These changes may include
exercising more frequently or quitting smoking.

The outlook for people with acute IC is often
poor because tissue death in the intestine frequently occurs before surgery.
The outlook is much better if you receive a diagnosis and start treatment right
away.

How can I prevent ischemic
colitis?

A healthy lifestyle can reduce your risk of
developing hardened arteries. The basics of a healthy lifestyle include:

exercising regularly

eating a healthy diet

treating heart conditions that
can lead to blood clots, such as an irregular heartbeat

monitoring your blood cholesterol
and blood pressure

not smoking

Your doctor may also recommend that you stop
taking any medication that can cause ischemic colitis. These drugs can include
certain antibiotics or heart and migraine medications. Make sure you tell your
doctor what medications you’re currently taking.

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.